Gunderson, Beverly J

Gunderson, Beverly J is an individual health care provider with primary practice located at 4400 W 69Th St Ste 1500, Sioux Falls SD 57108-8170. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Gunderson, Beverly J can be contacted via phone (605) 322-5700.

Contact Information

Primary practice address
4400 W 69Th St Ste 1500 Sioux Falls SD 57108-8170
Phone: (605) 322-5700
Fax: (605) 322-5704
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 195 South Dakota

Profile Details

NPI number 1124090642
LBN Legal business name Gunderson, Beverly J
Credentials ED.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Oct 11th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124090642 NPPES
South Dakota Other 680015878 RR MEDICARE
South Dakota Other P195 RR MEDICARE
South Dakota MEDICAID 12200 RR MEDICARE
South Dakota Other 412991028090 RR MEDICARE
South Dakota MEDICAID 581816800 RR MEDICARE
South Dakota Other 596332 RR MEDICARE
South Dakota Other 040121002 RR MEDICARE
South Dakota Other 10635 RR MEDICARE
South Dakota Other 57108C025 RR MEDICARE
South Dakota MEDICAID 46022474352 RR MEDICARE
South Dakota Other 0040485 RR MEDICARE
South Dakota Other 141M3GU RR MEDICARE
South Dakota MEDICAID 3989442 RR MEDICARE
South Dakota Other 122288 RR MEDICARE
South Dakota Other 28142 RR MEDICARE
South Dakota Other HP24855 RR MEDICARE
South Dakota MEDICAID 6550806 RR MEDICARE

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